Kanner discovered the disorder in 1943 and his name is used to describe “full-blown autism” which we won’t see in BRGS. Hans Asperger (1944) realised.

Kanner discovered the disorder in 1943 and his name is used to describe “full-blown autism” which we won’t see in BRGS.

Hans Asperger (1944) realised that the symptoms of intelligent autistic children were very different and that these children could go on to lead relatively normal lives.

At the time, autistic children were very rare, about 1 in a million.

In BRGS, we see children with Asperger’s Syndrome and as there are now better ways to help these children, the SPELL, the TEACCH and the ABA system, we will see more and more.

A few people with Asperger's syndrome are very successful and until recently were not diagnosed with anything but were seen as brilliant, eccentric, absent minded, socially inept, and a little awkward physically.

Diagnostic Criteria For 299.80 Asperger's Disorder (DSM IV)

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

1. marked impairments in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

2. failure to develop peer relationships appropriate to developmental level

3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)

4. lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

2. apparently inflexible adherence to specific, non-functional routines or rituals

3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

4. persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

Estimated population of autism spectrum disorders in the UK

The estimated numbers have been worked out from the population of the UK as given in the 2001 census: 58,789,194, of whom 13,354,297 were under 18.

The figure for children is based on the 1 in 100 prevalence rate and corrected to the nearest 100. The estimated number of children under 18 with an autism spectrum disorder (ASD) is 133,500.

We had four ASD students in school in September, but one left this term, unable to cope.

In 1998, Paul Boateng asked for local authorities to report on the numbers of ASD children in their area. These are the local responses.

Health Authorities North West England

Bury & Rochdale: has no data. Uses two published rates of incidence, then applies these to the total local population. This implies that there are between 8 and 348 cases in Bury, and between 10 and 434 cases in Rochdale (no typing errors here).

East Lancashire: does not have data on incidence of autism. Aware of increase in Aspergers, but ascribes this to better assessment.

ASDs (Autistic Spectrum |Disorders) are caused by a disorder in the brain, where the amygdala, which is supposed to unconsciously recognise faces, read body language and assess if a situation is dangerous, fails to sort the data properly and spreads the sensory data to the wrong parts of the brain.

As the amygdala is part of the fight or flight response, it constantly keeps the cerebellum in a state of alert, causing sensory overload and a state of fear, which the ASD student has to control.

Anomalies in the amygdala and other structures of the medial temporal lobe have been demonstrated repeatedly in autism spectrum disorders, suggesting involvement of the temporal pathway for visuoperceptual processing.

Functional magnetic resonance imaging (fMRI) of people with autism spectrum disorders demonstrates reduced activation in the fusiform gyrus, the portion of the brain associated with facial recognition, and increased activation of adjacent portions of the brain associated with recognition of objects.

fMRI also suggests that, in some individuals with Asperger syndrome and high-functioning autism, dysfunctional connections among limbic and paralimbic regions, the cerebellum, and the extrastriate visual cortices occur during the process of identification of the emotion expressed by faces and the gender of the face.

For the scientists!

Discovering that your child is autistic is described as being similar to a bereavement, in that the parent has lost the child that they could have had.

This is compounded by frustration, anger and even, possibly, guilt.

Parents of ASD students only become annoyed with staff if the teacher is ignorant about what the child requires or is insensitive to the child’s needs.

Parents of ASD children have a strong emotional link to their child because their child is so needy and the relationship between the teacher and the parent can easily be compromised if the teacher regards the parent as being precious, whilst the parent regards the teacher as callous and lacking understanding.

What mood are these people displaying?

“Well they all look pretty happy to me” – BRGS student.

“Sometimes I feel it coming. I have to rationalise it. I have to keep it on a very short chain.”

Student at BRGS.

Genes

A number of genes are implicated in the disorder, specifically a region of chromosome 11 and a specific gene called neurexin 1.

There are a number of possibilities:

•One gene is at fault.

•A combination of genes is at fault.

•The faulty gene(s) is(are) activated by an external event.

Supporting evidence

•Identical twins tend to both have ASD if one is affected, though to different degrees.

•Autism runs in families. (One woman had 6 ASD children!!!!!)

•Someone with an ASD has an 8% chance of having a child with an ASD.

•Boys are 4:1 more likely to have an ASD than girls

Last Updated: Monday, 19 February 2007, 03:15 GMT

Autism gene breakthrough hailed

Scientists have found new autism genes by scanning the largest collection of families with multiple cases of autism ever assembled.

The monumental task of studying the 1,200 families took more than 120 scientists from more than 50 institutions across 19 countries.

The work, described in Nature Genetics, implicates a region of chromosome 11 and a specific gene called neurexin 1.

"There will almost certainly be an interaction between several genes so this one discovery doesn't provide a complete answer and may not lead straight to a genetic test but it could be a key step in development for effective treatments as it provides a target for drug development."

Skuse (2000) has suggested that the gene or genes for autism are located on the X chromosome. Girls inherit X chromosomes from both parents, but boys only inherit one, from their mothers.

Skuse’s hypothesis is that the X chromosome which girls inherit from their fathers contains an imprinted gene which "protects" the carrier from autism, thus making girls less likely to develop the condition than boys.

Some children who have developed normally and happily have regressed dramatically at 15 months when given the MMR jab. Parents naturally blamed the jab and the government and drugs companies came out in force to refute that assertion.Some parents went to court on the issue and found that they could not pursue the case because they had lost their legal aid.

The Government has refused to offer single jabs which has compounded matters.

Anyone who speaks against the MMR is forced to recant or has to find work in America.

As a result, no research on the causative factors for ASDs, other than genetics, is happening in the UK.

The Government needs to have a take-up of 95% of children to keep the population safe. Most children are completely unaffected by the MMR jab and it is far more effective to have the three jabs as a combo, as some parents could choose which single jabs to avoid, leaving the population at risk.

•The measles virus (same DNA) has been found in the gut and spinal fluid of some children with ASD.

•The MMR jab, in the UK, used to be (not since 2004) stabilised with Thimerosal, a mercury compound. Mercury poisoning has similar symptoms to ASD. ASD children often show raised levels of heavy metals in their systems, showing an inability to detoxify themselves.

•The Japanese offered single jabs, but the autism levels rose. They still used Thimerosal in their jabs.

•The government has urged pregnant women not to eat more than two portions of oily fish a week because of the mercury levels in the fish.

•A Danish study has been quoted as proving that MMR does not lead to ASDs, but the Danes had previously stopped using the mercury. Further claims that the figures in Denmark had increased when the Thimerosal was not being used, were confused by the fact that the Danes were calculating their cases in a different way.

•Pre and Post 2004 figures for the UK are not available.

Children who have not had the jab still get ASDs. The MMR jab is not the whole answer.

Historically, mothers took their children to parties to catch the viruses that we inoculate against, because it was safer to catch the viruses young rather than as an adult. The dangerous effects like blindness, for measles, and deafness, for mumps, were rare because the mothers knew how to deal with the infections and could call the doctor out. Times have changed.

Would a teenage mother now know what to do?

It is easy to see why the Government is desperate for children to be fully immunised.

A large range of possibilities has been suggested:

• Child development - It just happens, because the child is at a specific stage of brain growth.

•Gut problems – children with ASD tend to have intestinal problems that could lead to gut leakage into the bloodstream. However, the question arises as to whether the autism led to the gut problem or vice versa.

•Viruses – autism is linked to at least 6 different viruses – with long names!

•Genetic abnormalities during pregnancy; we are better at saving babies that would have miscarried in the past.

•Problems in deliveries.

•Too much foetal scanning – ASD linked to twins.

In the 1960s lack of parental warmth was blamed for causing autism – this has been totally discredited.

Cognitive function: Autism occurs at all intelligence levels.

Although about 50% of autistic individuals have an intelligence quotient (IQ) below average, the other 50% have an average or above average intelligence. The performance IQ is generally higher than the verbal IQ. A small percentage have high intelligence in a specific area such as mathematics. (National Autistic Society)

ASD children cannot read other people’s body language and therefore they can’t empathise. There is a common misconception that they lack emotions. The opposite is true. Whereas we might think in words or in pictures, autistic children think through their emotions and emotional turbulence will block their thought processes as effectively as a dam.

“When you give me a problem to solve, first it stalls…der…der.. der and then happiness, and then the answer pops into my head.”

BRGS Pupil

Many people with Asperger's syndrome demonstrate gaze avoidance and may actually turn away at the same moment as greeting another.

They show a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people.

They may appear to be insensitive because they have not recognised how someone else is feeling

They may prefer to spend time alone rather than seeking out the company of other people

They may not seek comfort from other people

They may appear to behave 'strangely' or inappropriately, as it is not always easy for them to express feelings, emotions or needs.

Difficulties with social interaction can mean that people with autism find it hard to form friendships: some may want to interact with other people and make friends, but may be unsure how to go about this.

Pupils with autism often have difficulty recognising or understanding other people's emotions and feelings, and expressing their own, which can make it more difficult for them to fit in socially.

They may not understand the unwritten social rules which most of us pick up without thinking: they may stand too close to another person or too far away for example, or start an inappropriate subject of conversation. Their voices can be hectoring, monotonous in tone or too loud.

“Looking someone straight in the eyes, unexpectedly, is like getting an electric shock.”

Allow them to work alone if they wish to.

Organise a sensitive/patient buddy to socialise/work with them on their terms.

Don’t force them to do group work. Group work has to be very structured.

Tell them kindly but firmly if they go off at a tangent or are speaking too loudly.

Tell them verbally when they have done well.

Don’t tell them, “Look at me when I am talking to you.”

Encourage them to involve themselves in clubs that suit their interests.

Don’t expect them to read our body language.

"Socialising doesn't come naturally - we have to learn it."

Difficulties with social imagination should not be confused with a lack of imagination. Many people with autism are very creative and may be, for example, accomplished artists, musicians or writers.

understand and interpret other people's thoughts, feelings and actions

Social imagination allows us to understand and predict other people's behaviour, make sense of abstract ideas, and to imagine situations outside our immediate daily routine. Difficulties with social imagination mean that people with autism find it hard to:

predict what will happen next, or what could happen next

engage in imaginative role-play and activities

prepare for change and plan for the future

cope in new or unfamiliar situations

understand that other people don’t share their obsessions.

Rationalise what people do and why they do it.

Don’t expect ASDs to empathise – they intellectualise.

Have well-planned lessons where the students know what is going to happen.

If you plan a shock, let the ASD pupil know, even if the others don’t.

Let them be the judges for role-plays. Give them criteria for judging.

They can cope with something new if you warn them, and let them get out of the way if necessary.

If they need to project an idea into the future, let them use paper to intellectualise the problem.

"For people with autistic spectrum disorders, 'body language' can appear just as foreign as if people were speaking ancient Greek."

People with autism have difficulties with both verbal and non-verbal language. Many have a very literal understanding of language, and think people always mean exactly what they say. They can find it difficult to use or understand:

•facial expressions or tone of voice

•jokes and sarcasm

•common phrases and sayings; an example might be the phrase 'It's cool', which people often say when they think that something is good, but strictly speaking, means that it's a bit cold.

Others will have good language skills, but they may still find it hard to understand the give-and-take nature of conversations, perhaps repeating what the other person has just said (this is known as echolalia) or talking at length about their own interests.

It helps if other people speak in a clear, consistent way and give people with autism time to process what has been said to them.

Don’t tell them to pull their socks up.

At last someone has an excuse not to laugh at Kevin’s jokes.

Say what you mean – don’t assume that the pupil can pick up the nuances of your language.

Tell them if the way they converse is not appropriate, but kindly.

If you give an ASD student spoken instructions, they must have a written version. Any sensory upset will block the instructions.

Have a code so that they can flag to you when they don’t understand without looking foolish.

The understanding of hand gestures and eye gaze provides crucial clues about the feelings and intentions of others.

Persons with autism spectrum disorders exhibit deficits in facial perception.

Instead of identifying people on the basis of overall facial configuration, persons with autism spectrum disorders use the lower face, the mouth, and other specific portions of the face to identify others.

Thus, people with autism spectrum disorders actually may identify the faces of people by focusing on the objects that form the face rather than the whole person.

•Seizures (epilepsy) may develop in 25-35% of children with autism and can be resistant to treatment. The onset of seizures peaks in early childhood and again in adolescence.

•There is a high incidence of suicide amongst students with ASDs.

LIGHT

PEOPLE

CHAOS

SMELL

SOUND

Over-sensitive to perfumes, deodorants, bad smells etc

Between 100 and 500% more sensitive to sensual stimuli

Can have an emotional reaction to sensual stimulation that can lead to bouts of unconsciousness, blindness and deafness

Finds the sensual overload of a chaotic classroom very intimidating

Tend to need more personal space

Sensory sensitivity

People with autism may experience some form of sensory sensitivity. This can occur in one or more of the five senses - sight, sound, smell, touch and taste. A person's senses are either intensified (hypersensitive) or under-sensitive (hypo-sensitive).

For example, a person with autism may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain.

People who are hypo-sensitive may not feel pain or extremes of temperature. Some may rock, spin or flap their hands to stimulate sensation, to help with balance and posture or to deal with stress.

People with sensory sensitivity may also find it harder to use their body awareness system. This system tells us where our bodies are, so for those with reduced body awareness, it can be harder to navigate rooms avoiding obstructions, stand at an appropriate distance from other people and carry out 'fine motor' tasks such as tying shoelaces.

SMELL

Ensure that there is no stale food in the bins.

Discourage students from using deodorant in form rooms.

Be sensitive to ASD students in lab experiments.

Be prepared to move rooms if there is an unexpected issue.

LIGHT

Sensitive use of the blinds – now we have them.

Powerpoint backgrounds (colour) are better than Promethean (white) due to the glare. Some ASDs suffer from Irlen’s.

Don’t work in rooms with an undiffused fluorescent light

Avoid flashing lights in videos, experiments etc

Flashing classroom lights need to be switched off and repaired.

If you can’t avoid the problem, warn the student first.

SOUND

Avoid sudden shouting out, particularly from behind the student.

Allow the student to use headphones when working on his own.

Choose videos carefully or allow the student to sit away from the noise.

If you know it is going to be a noisy lesson, warn them first and let them leave if they need to.

CHAOS

The world can seem a very unpredictable and confusing place to people with autism, who often prefer to have a fixed daily routine so that they know what is going to happen every day. Rules can also be important: it may be difficult for a person with autism to take a different approach to something once they have been taught the 'right' way to do it. People with autism may not be comfortable with the idea of change, but can cope well if they are prepared for it in advance.

The worst place in BRGS is the corridors. ASDs should be allowed to use dark glasses and earphones to block the senses and the panic.

There should be a quiet room, with white walls for them to escape to.

Lessons should have a predictable structure, little disruption and be calm.

Shouting at an ASD student is extraordinarily counter-productive. Time-outs are better.

Kinaesthetic lessons must be very sensitively handled.

On the whole they are:

Honest

Brilliant researchers

Good at working on their own

Self-motivated

Bright

Relentless and determined.

Self-disciplined

Mature for their age

Intellectually unafraid

Lateral thinkers

They have initiative

BACKGROUND READINGAutism Spectrum Disorders by Chantal Sicile-Kira

The Curious Incident of the Dog in the Night-time by Mark Haddon

Freaks, Geeks and Asperger Syndrome: A User Guide to Adolescence by Luke Jackson

www.aspergers.com

www.aswhatisit.html

www.autism.jsp.htm

www. APERGERS%20SCHOOL.jsp.htm

www.Autism_Genetics.htm

www. Autism%20BBC%20genome.htm

A special thank you to:

Terri Spokes – Autistic Unit Woodhey High School

Angela Holdsworth – Tor View School

And especially to Huw and Matthew.

www.Big%20Picture%20autism.htm

www.autismfaq-hist.html

www.autism%20numbers2.htm

www.Autism%20numbers.htm and others

www.autismuk.com/index4.htm